Provider Demographics
NPI:1649681297
Name:WENDER, JOHANNA SARAH (MA, LMHC)
Entity type:Individual
Prefix:MRS
First Name:JOHANNA
Middle Name:SARAH
Last Name:WENDER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:MISS
Other - First Name:JOHANNA
Other - Middle Name:SARAH
Other - Last Name:STERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1033 SW 152ND ST
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-1845
Mailing Address - Country:US
Mailing Address - Phone:206-427-4360
Mailing Address - Fax:206-243-5321
Practice Address - Street 1:1033 SW 152ND ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-1845
Practice Address - Country:US
Practice Address - Phone:206-427-4360
Practice Address - Fax:206-243-5321
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60432644101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health